Survival benefit of tamoxifen therapy in adenocarcinoma of pancreas. A case-control study

Abstract

Background. Clinical data suggest tamoxifen may improve the survival of patients with unresectable ductal adenocarcinoma of pancreas. Methods. Eighty patients (50 women and 30 men) with biopsy-documented unresectable or incompletely resected ductal adenocarcinoma of the pancreas were treated with 20 mg of tamoxifen twice daily. The survival of the tamoxifen-treated group was compared with that of a case-control group of another 80 patients with pancreatic cancer, matched for age, sex, TNM stage, and bypass procedure versus biopsy. Results. The median survival times for the tamoxifen-treated group versus controls were 7 and 3 months, respectively (P < 0.0001). For women older than 60 years of age and treated with tamoxifen, the median survival time was 12 months. Multivariate analysis of the 160 patients showed that tamoxifen therapy, female sex, absence of metastases at diagnosis, and bypass procedure are all of independent prognostic significance for prolonged survival. Conclusions. Patients with unresectable or incompletely resected ductal adenocarcinoma of pancreas may have a prolonged survival benefit while receiving tamoxifen treatment. This potential benefit is most prominent in older women.